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1417331331

NPI Code Detail

MEDICARE: MD DIDAR UL ALAM MD

MEDICARE: MD DIDAR UL ALAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD465393	PA
2	207RP1001X	Pulmonary Disease Physician	D0096509	MD
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	D0096509	MD

General Provider Information

NPI Number	:	1417331331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MD DIDAR UL ALAM MD

Provider Business Mailing Address
First Line	:	1 TECH PARK DR
Second Line	:	STE 1150
City	:	JOHNSTOWN
State	:	PA
Zip	:	15901-2515
Country	:	US
Telephone Number	:	814-475-8700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BROOKDALE PLZ
Second Line	:	SUITE 134 CHC
City	:	BROOKLYN
State	:	NY
Zip	:	11212-3139
Country	:	US
Telephone Number	:	718-240-6347
Fax Number	:	718-240-6516

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2015
Last Update Date	:	06/25/2026

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Directions to “ MD DIDAR UL ALAM MD” Practice Location

Language	Start Address	Practice Location

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